Chen Ye, Wu Jinlan, Ran Lei, Yu Dan, Chen Xi, Liu Maodong
Department of Nephrology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Nutrition, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Front Nutr. 2022 Nov 15;9:1036796. doi: 10.3389/fnut.2022.1036796. eCollection 2022.
There are limited studies on phase angle and sarcopenia in continuous ambulatory peritoneal dialysis patients. So, we want to explore the association between phase angle and sarcopenia and find a more sensitive indicator for diagnosing sarcopenia.
We included 101 continuous ambulatory peritoneal dialysis patients from March 2022 to August 2022 and measured the phase angle and body composition by bioelectrical impedance analysis. All patients had their handgrip strength measured. Then, we divided patients into the sarcopenia ( = 30) group and non-sarcopenia ( = 71) group according to the sarcopenia diagnostic strategy formulated by the Asian Working Group for Sarcopenia. We used logistic regression to explore the risk factors of sarcopenia. We applied Receiver-operating characteristics curves to determine the diagnostic accuracy of these risk factors.
After adjustments for sex, age, diabetes, BMI, extracellular water ratio, extra water, serum creatinine, total kt/v, and residual kt/v, phase angle correlated to handgrip strength and lowered limb muscle mass but not to skeletal muscle mass, upper arm muscle circumference, upper limb muscle mass and appendicular skeletal muscle mass index. In the multivariate logistic model, low phase angle and older age are risk factors for sarcopenia. The AUROC of phase angle for sarcopenia is 0.79 (95%CI, 0.70-0.86, < 0.01) for both sexes, 0.70 and 0.85 for females and males. After we combined age and phase angle as diagnostic indicators of sarcopenia, the AUROC is 0.91 (95%CI, 0.83-0.96, < 0.0001) in both sexes, 0.89 and 0.93 for females and males.
This study illustrates that age 52 or older is an independent risk factor for sarcopenia in continuous ambulatory peritoneal dialysis patients. Phase angle can act as a predictor of sarcopenia in those patients. But the combination of age and phase angle is more valuable in diagnosing sarcopenia.
关于持续非卧床腹膜透析患者的相位角与肌肉减少症的研究有限。因此，我们想探讨相位角与肌肉减少症之间的关联，并找到一个更敏感的肌肉减少症诊断指标。
我们纳入了2022年3月至2022年8月期间的101例持续非卧床腹膜透析患者，并通过生物电阻抗分析测量了相位角和身体成分。所有患者均测量了握力。然后，根据亚洲肌肉减少症工作组制定的肌肉减少症诊断策略，将患者分为肌肉减少症组（n = 30）和非肌肉减少症组（n = 71）。我们使用逻辑回归来探讨肌肉减少症的危险因素。我们应用受试者工作特征曲线来确定这些危险因素的诊断准确性。
在对性别、年龄、糖尿病、体重指数、细胞外水比率、多余水分、血清肌酐、总Kt/V和残余Kt/V进行校正后，相位角与握力和下肢肌肉量降低相关，但与骨骼肌量、上臂肌肉周长、上肢肌肉量和四肢骨骼肌量指数无关。在多变量逻辑模型中，低相位角和高龄是肌肉减少症的危险因素。相位角对肌肉减少症的受试者工作特征曲线下面积（AUROC）在两性中均为0.79（95%可信区间，0.70 - 0.86，P < 0.01），女性为0.70，男性为0.85。在我们将年龄和相位角作为肌肉减少症的诊断指标进行合并后，两性的AUROC均为0.91（95%可信区间，0.83 - 0.96，P < 0.0001），女性为0.89，男性为0.93。
本研究表明，52岁及以上是持续非卧床腹膜透析患者发生肌肉减少症的独立危险因素。相位角可作为这些患者肌肉减少症的预测指标。但年龄和相位角的联合在诊断肌肉减少症方面更有价值。
